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Rhinitis is defined as inflammation of the nasal membranes[1] and is characterized by a symptom complex that consists of any combination of the

following: sneezing, nasal congestion, nasal itching, and rhinorrhea. [2] The eyes, ears, sinuses, and throat can also be involved. Allergic rhinitis is the most common cause of rhinitis. It is an extremely common condition, affecting approximately 20% of the population. While allergic rhinitis is not a life-threatening condition, complications can occur and the condition can significantly impair quality of life,[3, 4] which leads to a number of indirect costs. The total direct and indirect cost of allergic rhinitis was recently estimated to be $5.3 billion per year.[5] Allergic rhinitis involves inflammation of the mucous membranes of the nose, eyes, eustachian tubes, middle ear, sinuses, and pharynx. The nose invariably is involved, and the other organs are affected in certain individuals. Inflammation of the mucous membranes is characterized by a complex interaction of inflammatory mediators but ultimately is triggered by an immunoglobulin E (IgE)mediated response to an extrinsic protein.[6] The tendency to develop allergic, or IgE-mediated, reactions to extrinsic allergens (proteins capable of causing an allergic reaction) has a genetic component. In susceptible individuals, exposure to certain foreign proteins leads to allergic sensitization, which is characterized by the production of specific IgE directed against these proteins. This specific IgE coats the surface of mast cells, which are present in the nasal mucosa. When the specific protein (eg, a specific pollen grain) is inhaled into the nose, it can bind to the IgE on the mast cells, leading to immediate and delayed release of a number of mediators.[6, 7, 8] The mediators that are immediately released include histamine, tryptase, chymase, kinins, and heparin.[7, 8] The mast cells quickly synthesize other mediators, including leukotrienes and prostaglandin D2.[9, 10, 11] These mediators, via various interactions, ultimately lead to the symptoms of rhinorrhea (ie, nasal congestion, sneezing, itching, redness, tearing, swelling, ear pressure, postnasal drip). Mucous glands are stimulated, leading to increased secretions. Vascular permeability is increased, leading to plasma exudation. Vasodilation occurs, leading to congestion and pressure. Sensory nerves are stimulated, leading to sneezing and itching. All of these events can occur in minutes; hence, this reaction is called the early, or immediate, phase of the reaction. Over 4-8 hours, these mediators, through a complex interplay of events, lead to the recruitment of other inflammatory cells to the mucosa, such as neutrophils, eosinophils, lymphocytes, and macrophages.[12] This results in continued inflammation, termed the late-phase response. The symptoms of the late-phase response are similar to those of the early phase, but less sneezing and itching and more congestion and mucus production tend to occur.[12] The late phase may persist for hours or days. Systemic effects, including fatigue, sleepiness, and malaise can occur from the inflammatory response. These symptoms often contribute to impaired quality of life.

Rhinitis
Rhinitis is inflammation of the mucous lining of the nose. Rhinitis (pronounced commonly known as a stuffy nose, is the medical term describing irritation and inflammation of some internal areas of the nose. The primary symptom of rhinitis is nasal dripping. It is caused by chronic or acute inflammation of the mucous of the nose due to viruses, bacteria or irritants. The inflammation results in the generating of excessive amounts of mucus, commonly producing the aforementioned runny nose, as well as nasal congestion and post-nasal drip. According to recent studies completed in the United States, more than 50 million Americans are current sufferers. Rhinitis has also been found to adversely affect more than just the nose, throat, and eyes. It has been associated with [1] sleeping problems, ear conditions, and even learning problems. Rhinitis is caused by an increase in histamine, which is most often triggered by airborne allergens. These allergens may affect an individual's nose, throat, or eyes and cause an increase in fluid production within these areas. Rhinitis is commonly caused by a viral or bacterial infection, including the common cold, which is caused by Rhinoviruses and Corona viruses, or bacterial sinusitis. Symptoms of the common cold include rhinorrhea, sore throat (pharyngitis), cough, congestion, and slight headache. Description Rhinitis is a nonspecific term that covers infections, allergies, and other disorders whose common feature is the location of their symptoms. In rhinitis, the mucous membranes become infected or irritated, producing a discharge, congestion, and swelling of the tissues. The most widespread form of infectious rhinitis is the common cold. The common cold is the most frequent viral infection in the general population, causing more absenteeism from school or work than any other illness. Colds are self-limited, lasting about 3-10 days, although they are sometimes followed by a bacterial infection. Children are more susceptible than adults; teenage boys more susceptible than teenage girls; and adult women more susceptible than adult men. In the United States, colds are most frequent during the late fall and winter. Causes and symptoms Colds can be caused by as many as 200 different viruses. The viruses are transmitted by sneezing and coughing, by contact with soiled tissues or handkerchiefs, or by close contact with an infected person. Colds are easily spread in schools, offices, or any place where people live or work in groups. The incubation period ranges between 24 and 72 hours. The onset of a cold is usually sudden. The virus causes the lining of the nose to become inflamed and produce large quantities of thin, watery mucus. Children sometimes run a fever with a cold. The inflammation spreads from the nasal passages to the throat and upper airway, producing a dry cough, headache, and watery eyes. Some people develop muscle or joint aches and feel generally tired or weak. After several days, the nose becomes less inflamed and the watery discharge is replaced by a thick, sticky mucus. This change in the appearance of the nasal discharge helps to distinguish rhinitis caused by a viral infection from rhinitis caused by an allergy. Diagnosis There is no specific test for viral rhinitis. The diagnosis is based on the symptoms. In children, the doctor will examine the child's throat and glands to rule out measles and other childhood illnesses that have similar early symptoms. Adults whose symptoms last longer than a week may require further testing to rule out a secondary bacterial infection, or an allergy. Bacterial infections can usually be identified from a laboratory culture of the patient's nasal discharge. Allergies can be evaluated by blood tests, skin testing for specific substances, or nasal smears.

Treatment There is no cure for the common cold; treatment is given for symptom relief. Medications include aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) for headache and muscle pain, and decongestants to relieve stuffiness or runny nose. Patients should be warned against overusing decongestants, because they can cause a rebound effect. Over-the-counter (OTC) antihistamines are also available; however, most antihistamines carry warnings of drowsiness and the inability to do some tasks while medicated. Claritin is a prescription-strength OTC non-drowsy antihistamine that helps relieve symptoms of rhinitis. Antibiotics are not given for colds because they do not kill viruses. Supportive care includes bed rest and drinking plenty of fluid. Treatments under investigation include the use of ultraviolet light and injections of interferon. Many prescription and over-the-counter drugs are available to help control the symptoms of allergic rhinitis. The most common class is antihistamines. Prevention There is no vaccine effective against colds, and infection does not confer immunity. Prevention depends on: washing hands often, especially before touching the face minimizing contact with people already infected not sharing hand towels, eating utensils, or water glasses.